Evaluation of NSW Health drug and alcohol consultation liaison services
Key Objectives
To investigate the prevalence of alcohol and other drug related hospital presentations and the effectiveness of enhanced Drug and Alcohol Consultation Liaison services
Drug and alcohol morbidity is common amongst patients presenting at emergency departments yet frequently unidentified. This increases the risk of inappropriate treatment and management of patients. Issues including post operative morbidity and behavioural incidents as well as higher rates of re-presentation, re-admission and re-injury are associated with drug and alcohol related presentations. The aim of this evaluation is to assess the effectiveness and cost-effectiveness of Drug and Alcohol Consultation Liaison (CL) services in NSW. Consultation Liaison (CL) services are a sub-specialty of psychiatry, to provide direct access to specialist services for support, treatment advice and assistance with the management of the condition. In NSW a number of health services have been funded to provide enhanced Drug and Alcohol CL services to reduce the health burden and associated costs that drug and alcohol problems place on the health system.
The evaluation will use data from a survey of a sample of patients presenting to eight NSW hospitals to determine the proportion of presentations where drug and alcohol use was a contributing factor and the proportion of patients with a recent substance use problem. A follow-up survey will be conducted at three months with those patients identified through the survey as having a recent substance use problem to assess the use of CL services, uptake of referral to drug and alcohol treatment, and the extent to which CL services impact on client outcomes (e.g. substance use patterns). This study includes seeking consent to access the patient’s medical records, including Medicare data and NSW inpatient, emergency department and Area Health Service CL data. The results of these surveys will be combined with information about the resources and funding of CL services, as well as any resource savings from reduced admissions to assess the costs and outcomes of CL services. The focus will be on identifying whether there are factors that contribute to more cost-effective provision (such as hours of operation), or any characteristics of CL service provision that facilitate improved patient management and clinical pathways. The evaluation will also make use of aggregate data on drug and alcohol presentations in NSW public hospitals to identify any underlying trends in patterns of service.
The evaluation commenced on 1 November 2010. Site visits have been undertaken at participating hospitals and patient surveys have commenced. The evaluation team have applied for and obtained ethics approval to access Medicare and Pharmaceutical Benefits data from Medicare Australia, and NSW Inpatient and Emergency Department data, for consenting participants.
Funding source
NSW Department of Health
CHERE staff
Rosalie Viney, Rebecca Reeve, Kees van Gool, Stephen Goodall, Stephanie Knox, Patsy Kenny
Collaborators
Catherine Montigny (CI)1, Lucy Burns2, Elizabeth Conroy2, Kerryn Butler2, Tim Slade2, Elizabeth Savage3, Meliyanni Johar3
1. Mental Health Drug and Alcohol Office (MHDAO), NSW Department of Health
2. National Drug and Alcohol Research Centre (NDARC), UNSW
3. Department of Economics, UTS
